Resorption Of Tumor Research Articles

THE ROLE OF MRI SCAN WITH CONTRAST AMPLIFICATION AT MULTI-PARAMETRIC MRI IN OPTIMIZATION OF X-RAY THERAPY OF RECURRENT CANCER OF PROSTATE

The purpose of study is to evaluate the role of dynamic contrast intensification as a constituent of multi-parametric MR-therapy in diagnostic of clinical recurrence of prostate cancer and optimization of salutary X-ray therapy. Materials and method. The sampling consisted of 89 patients with marker (prostate specific antigen) prostate cancer recurrence after radical prostate ectomy. The preliminary examination established no distant metastases. The multi-parametric MR-imaging of pelvis minor was applied both before salutary X-ray therapy and 6 months later after with purpose of applied treatment control. In 44 patients’ analysis was applied to data of dynamic MR-imaging with contrast intensification constituent to multi-parametric MR-imaging with intravenous injection of various MR-mediums (1M Gadobutrol, ½M Gadodiamid and ½M Gadoversetamid). The results. The model of multiple linear regression was applied to demonstrate that square of substrate of clinical recurrence statistically reliably correlates with level of marker of prostate specific antigen (R = 0,74; p < 0,0008) independently of type of injected various MR-mediums. The sensitivity of multi-parametric MR-imaging in detection of clinical recurrence of prostate cancer was evaluated by comparison with levels of prostate specific antigen and amounted to 92%, specificity - to 82%, accuracy - to 88%. The application of technique of hypo-fractionating of radiation dose on area of clinical recurrence of prostate cancer detected by multi-parametric MR-imaging demonstrated more progressive decreasing of marker of prostate specific antigen as compared with standard scheme of salutary X-ray therapy (according McNemarre criterion p < 0,03). The statistically reliable dependence (Mann-Whitney criterion p < 0,018) of alteration of signal in case of dynamic MR-imaging with contrast intensification after intravenous injection of various MR-mediums from square of substrate of clinical recurrence of prostate cancer and initial concentration of injected various MR-mediums between 1M Gadobutrol and ½M Gadodiamid and ½M Gadoversetamid. Conclusion. The multi-parametric MR-imaging has high sensitivity, specificity and accuracy in detection of substrate of clinical recurrence of prostate cancer. The application of in initial concentration of 1M (Gadobutrol) reliably increase validity of detection of local clinical relapse of prostate cancer especially in case of detection of substrate of recurrence of enough little and extra-little sizes. The application of multi-parametric MR-imaging using various MR-mediums marker in initial concentration of 1M (Gadobutrol) prior to course of salutary X-ray therapy enables to plan a supposed zone of X-ray impact with the purpose of more personalized brining of of high tumorocide dose of radiation at the area of clinical recurrence of prostate cancer needed for full resorption of recurrent tumor.

Effectiveness of brachytherapy in the combination treatment of retinoblastoma

Background: Retinoblastoma is a malignant tumor of the eye retina that occurs mostly in children. In the absence of treatment, the disease leads not only to vision loss, but also to death of the child. At present, combined organ-preserving methods of treatment are preferred. These include polychemotherapy and a local intervention on the tumor, the "golden standard" of which being brachytherapy. Aim: To study the effectiveness of brachytherapy against the background polychemotherapy. Materials and methods : We analyzed retrospectively medical files of 104 children with retinoblastoma aged from 5 months to 5 years (mean age 21 months), who underwent brachytherapy as a local component of management from 2010 to 2015 in the Moscow Helmholtz Research Institute of Eye Diseases. Multifocal lesions were identified in 43 cases and bilateral tumors in 87 children. In 33 cases, the worst eye was removed. Endophytic and mixed forms of tumors growth were most prevalent. Before the brachytherapy, all children received polychemotherapy (2 to 3 courses). The average tumor thickness was 2.74 mm (from 1 to 6.4 mm); its mean maximal transverse dimension was 6.27 mm. Indigenous ophthalmic applicators with isotopes 90 Sr + 90 Y and 106 Ru + 106 Rh were used. The average dose on the tumor apex with the strontium applicator was 142.1 (120–170) Gy, with ruthenic one, 107.4 (69–168) Gy; the scleral doses were 751.3 и 504.4 Gy, respectively. The median follow-up was 51 months. The patients were assessed every 3 to 4 months with ophthalmoscopy and ultrasound examination. The following effectiveness criteria were used: complete resorption, the tumor cannot be identified; partial resorption, a decrease in the initial tumor size by at least 50%; no effect, a decrease in the initial tumor size by less than 50% or an increase in the size of the tumor. Results: Complete resorption of the tumor occurred in 60.6% (n = 63) of the patients at 3 months and in additional 24% (n = 25) at 6 months. During the first year after the radiation, complete resorption of retinoblastoma was achieved 93.3% (n = 97) of the children. All children are alive, no distant metastases have been found. Early complications after brachytherapy were noted in 3 children: hemophthalmia, in 1, retinal detachment, in 1, hemophthalmia with retinal detachment, in 1, when the radiation dose on the sclera exceeded 1000 Gy. Continued tumor growth or relapses were detected in 7 (6.7%) patients. The reason to enucleate two eyes was the tumor invasion into the orbit (1.9%). Visual functions are preserved in 85 (81.7%) children, with a high visual acuity (0.9–1.0) in 21 children, and 0.1–0.8 in 21 children, as well. Conclusion : Brachytherapy is a highly effective method of local destruction of retinoblastoma, which, in the vast majority of cases, allows for complete resorption of the irradiated tumor and for maintenance of high visual acuity in almost half of patients.